Stages of vulvar cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. The healthcare team uses information from tests to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Doctors use the stage to plan treatment and estimate the outcome (prognosis).

The most common staging system for vulvar cancer is the FIGO system. For vulvar cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the larger the cancer is or the more the cancer has spread.

When describing the stage, doctors may use the words local, regional or distant.

Local means that the cancer is only in the vulva and has not spread to other parts of the body. This may also be called early-stage cancer.

Regional means the cancer has spread to nearby lymph nodes or organs. This may also be called locally advanced cancer.

Distant means the cancer has spread to a part of the body farther from the vulva. This may also be called metastatic cancer.

Talk to your doctor if you have questions. Find out more about staging cancer.

The tumour is only in the vulva or is only in the vulva and the perineum (the area between the vagina and anus).

Stage 1 can be divided into stages 1A and 1B.

Stage 1A means that the tumour is 2 cm or smaller and has grown into the skin and tissues by 1 mm or less.

Stage 1B means that the tumour is larger than 2 cm or has grown into the skin and tissues by more than 1 mm.

The tumour can be any size. The cancer has grown into the lower part of the urethra, lower part of the vagina or lower part of the anus. It has not spread to nearby lymph nodes.

The tumour can be any size. The cancer has grown into the upper part of nearby perineal structures, or it has spread to nearby lymph nodes in the groin.

Stage 3 can be divided into stages 3A, 3B and 3C.

Stage 3A means that the cancer has grown into the upper part of the urethra, the upper part of the vagina, the bladder mucosa or the rectal mucosa. Or it has spread to nearby lymph nodes that are 5 mm or smaller.

Stage 3B means that the cancer has spread to nearby lymph nodes that are larger than 5 mm.

Stage 3C means that the cancer has spread to the lymph nodes and has also spread outside the lymph node capsule.

The tumour can be any size.

Stage 4 can be divided into stages 4A and 4B.

Stage 4A means that the cancer has spread to the pelvic bone or nearby lymph nodes. These lymph nodes are firmly attached to surrounding tissues (fixed) or have broken open (ulcerated).

Stage 4B means that the cancer has spread to other parts of the body farther away from the vulva. This is also called metastatic cancer.

Recurrent vulvar cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.